In the year ending March 2025, health and social care accounted for approximately 33% of all sponsor licence revocations in the UK. One in three businesses that lost the right to sponsor overseas workers was a care provider. Not tech companies. Not hospitality chains. Care homes, domiciliary care agencies, and nursing facilities — the organisations that look after the most vulnerable people in the country.
This is not a coincidence. The care sector sits at the intersection of every factor that makes right to work compliance difficult: chronic staffing shortages, heavy reliance on overseas workers, high turnover, agency staff rotating between sites, stretched HR capacity, and regulatory scrutiny from multiple directions simultaneously.
If you run or manage a care organisation, right to work compliance is not just an immigration issue. It is a regulatory, operational, and safeguarding issue that connects directly to your CQC rating, your ability to recruit, and your licence to operate.
Why care is the hardest sector for RTW compliance
The staffing equation
Adult social care in England employs approximately 1.5 million people. Vacancy rates have hovered above 9% for years. Staff turnover sits at around 29%. These are not numbers that allow for leisurely, meticulous compliance processes.
When a night shift needs covering and the only available worker comes through an agency at two hours' notice, the priority is getting someone on the floor, not conducting a careful document review. This pressure — entirely understandable from an operational standpoint — is exactly what creates the compliance gaps that the Home Office targets.
The sector's response to chronic vacancies has been to sponsor overseas workers at an unprecedented scale. The number of care organisations holding sponsor licences grew dramatically after the Health and Care Worker visa was introduced, making it easier to recruit from abroad. But obtaining a licence is the beginning of the compliance obligation, not the end.
Multiple regulators, overlapping requirements
Care providers face a regulatory landscape that most other sectors do not. The Home Office monitors sponsor compliance. The Care Quality Commission inspects the quality and safety of care. Local authority commissioners assess whether you meet their contract requirements. And now the Fair Work Agency adds another enforcement layer focused on employment compliance.
These regulators do not operate in silos. CQC assessors reviewing your "Safe" domain will look at recruitment records, including right to work documentation. If they find gaps, it affects your CQC rating — which affects your ability to win local authority contracts, which affects your revenue.
A CQC inspection that uncovers right to work documentation gaps can trigger a referral to the Home Office. A Home Office compliance visit that finds workers not doing the roles described on their Certificates of Sponsorship can raise questions about the care being delivered. The regulatory threads are interconnected, and a failure in one area pulls on all of them.
Agency staff: the compliance blind spot
Care homes rely heavily on agency and temporary workers to fill staffing gaps. A large care home might use 15-20 different agency workers in any given month. Some of those workers will appear once and never return. Others might work regular shifts across multiple homes simultaneously.
The compliance question is deceptively simple: who is responsible for the right to work check — the agency or the care home?
The legal answer: both. The agency has a responsibility to check the right to work of the people it employs. But the care home, as the end hirer, also needs to establish its own statutory excuse. Relying on the agency's assurance is not sufficient.
In practice, this means care homes should be verifying right to work status for every agency worker, every time. Not just the first time they appear. The challenge is doing this at scale, at speed, and without creating delays that leave shifts uncovered and residents without care.
What CQC is looking for
CQC's single assessment framework assesses care providers across five key questions: Safe, Effective, Caring, Responsive, and Well-led. Right to work compliance touches at least three of these.
Safe. Regulation 19 (Fit and proper persons employed) requires that all staff, including temporary and agency workers, are properly vetted before they provide care. CQC assessors will review recruitment files and expect to see: identity verification, DBS checks, right to work checks, professional registration (where applicable), and references.
Well-led. CQC expects governance systems that ensure compliance. If your process depends on one person remembering to check, your system is not well-led. CQC wants embedded processes, not individual effort.
Effective. Workers need the skills and qualifications for their roles. Sponsored nurses need current NMC registration. Sponsored carers need evidence of required qualifications.
The overlap between CQC and Home Office requirements means a single compliance system can address both — but a failure in one area has consequences in both.
The specific challenges care providers face
Challenge 1: Multi-site operations
Many care organisations operate across multiple locations. Each site may have its own manager, its own filing system, and its own approach to compliance. Standardising the right to work process across 5, 10, or 50 sites is a significant operational challenge.
When the Home Office visits one site, they may request records for workers based at another. If those records are stored locally at each site and are not centrally accessible, producing them takes time. Time that the compliance officer will note.
Challenge 2: High turnover and short tenure
Care has one of the highest turnover rates of any UK sector. A worker who joins in January and leaves in April still needs a complete compliance record. If you are processing 30 new starters a month and losing 25, the administrative burden of maintaining compliant records is substantial.
The temptation — and the common failure — is to deprioritise the paperwork when someone is clearly temporary. But the penalty applies regardless of tenure. A worker who was with you for one week without a valid right to work check carries the same £45,000 first-offence penalty as one who was with you for five years.
Challenge 3: Visa expiry tracking at scale
Care providers with large numbers of sponsored workers may have dozens of visa expiry dates to track simultaneously. A medium-sized care group with 50 sponsored workers across multiple sites could have visa expiry dates spread across every month of the year.
Missing a single expiry — failing to conduct the follow-up right to work check before the worker's permission lapses — means your statutory excuse has lapsed too. The worker may still have the right to work (if they have applied for an extension, for example), but you need to verify that. Tracking these dates manually is a systemic risk.
Challenge 4: The knowledge gap
Many care home managers are promoted from clinical or care backgrounds. They are experts in care delivery, not immigration compliance. The expectation that a care home manager will understand the nuances of Certificates of Sponsorship, the SMS reporting system, the difference between a manual check and an IDSP check, and the 10-day reporting deadlines is — frankly — unrealistic without proper training and support.
This knowledge gap is not a personal failing. It is a structural issue in how the care sector has been required to absorb an enormous increase in immigration compliance obligations without a corresponding increase in compliance infrastructure.
What care providers should do
1. Centralise your compliance records
This is the single most impactful change. Every worker — permanent, agency, bank — should have a compliance record accessible from one system, regardless of which site they work at. When CQC visits Site A and asks about a worker who is based at Site B but did a shift last Tuesday, you need to produce that record immediately.
2. Build a robust audit trail
For every worker, record: what was checked, when, by whom, what documents were presented, and what the outcome was. For sponsored workers, add: CoS reference, visa expiry date, reporting history, and follow-up check dates.
This audit trail serves double duty. It satisfies the Home Office if they visit, and it satisfies CQC assessors reviewing your recruitment records.
3. Automate expiry tracking
Do not rely on a spreadsheet and someone remembering to check it. Automated alerts — triggered 90, 60, and 30 days before a visa expires — ensure that follow-up checks happen on time, every time. The cost of automation is a fraction of the cost of a single missed expiry.
4. Establish agency worker verification at point of arrival
Work with your agencies to ensure that every agency worker can be verified at the point they arrive for a shift. This might mean requiring agencies to provide compliance documentation in advance, or implementing a verification process at check-in. The current model — where an agency worker arrives, gets a lanyard, and starts caring for residents without real-time verification — is a safeguarding and compliance risk that regulators are increasingly unwilling to accept.
5. Train your managers
Every site manager who is responsible for checking right to work documentation needs to understand: what constitutes a valid check, which method to use for which worker type, what to do if a check fails, and when to escalate. This needs regular refresher training, particularly when the rules change.
6. Prepare for the crossover inspection
Assume that a CQC inspection will ask about right to work compliance, and that a Home Office visit will ask about the care being delivered. The organisations that handle crossover inspections best are those where compliance is embedded in daily operations, not treated as a separate function.
The bigger picture
The care sector's compliance challenge is not getting easier. Demand for care workers grows as the population ages. Domestic recruitment cannot fill the gap. International recruitment will remain essential. And with essential recruitment comes essential compliance. The cost of a proper compliance system is a rounding error compared to the cost of losing your sponsor licence, your CQC rating, or your local authority contracts.
Certifyd's Right to Work Portal is built for the specific challenges care providers face — multi-site operations, high turnover, agency worker verification, and automated visa expiry tracking. One system for both Home Office and CQC compliance, with audit-ready records available from any site, at any time. Learn more about how Certifyd supports the care sector.